President Trump Issues Drug Pricing Executive Orders
Today President Trump issued four executive orders to decrease the cost of drugs in the United States. One of the executive orders issued today revives the rebate rule for Medicare Part D, which passes rebate savings to patients at the point of sale at the pharmacy counter, and directs Secretary Azar to complete the rulemaking process begun in 2019.
Additionally, President Trump issued a directive to CMS, effective on August 25, 2020, to set reimbursement rates to the lowest price paid in comparable OECD countries (Most Favored Nation) for Medicare Part B drugs. The Administration also would permit States, wholesalers, and pharmacies to import FDA approved drugs from foreign countries to the U.S. for resale. Finally, there is a directive for federally funded community health centers to pass 340B discounts they receive for insulin and Epipens directly to low income patients.
NCPA will continue to provide comments as HHS moves all of these regulatory actions, including the rebate rule, through the rulemaking process.
NCPA to President Trump: No Rebate Rule
Without Fixing Pharmacy DIR
With talk of an imminent executive order on drug pricing, NCPA sent a letter to President Trump and issued a subsequent news release reiterating the association’s stance on the removal of the current system of safe harbor protections for rebates involving prescription pharmaceuticals and the creation of a safe harbor protection for certain point of sale reductions in price on prescription pharmaceuticals. In the letter, NCPA outlined what we believe to be the minimum requirements in such an order, including fixing pharmacy DIR fees. The beltway publication Politico also reported on NCPA's letter.
Outline of Senate COVID Bill Indicates
NCPA Essential Priorities May Be Included
It was expected that Senate Majority Leader Mitch McConnell (R-Ky.) would release his first draft of a coronavirus relief package this week. While a formal bill was not introduced, Sen. McConnell did release an outline of potential items that would be included such as NCPA’s essential priorities of liability reform, a second round of PPP, streamlined loan forgiveness, and employer tax deduction for the purchase of PPE. It is now expected that Sen. McConnell will introduce the bill next week. This will simply be the first of many drafts as negotiations with Senate and House Democrats have not yet begun in earnest meaning passage may slip into August. Contact your legislators and urge them to support inclusion of NCPA’s Essential priorities.
Deadline Extended for Provider Relief Fund Application
HHS has extended the deadline for applications for the CARES Act Provider Relief Fund Medicaid/CHIP distribution to Aug.3, 2020. Don’t wait – It’s highly recommended that you submit an application for the Medicaid/CHIP distribution whether or not you received the earlier General Distribution targeted at Medicare providers. Learn more information regarding the application process here.
Federal Government Reportedly Investigating
Largest Medicaid Managed Care Provider
According to the Ohio Capital Journal, federal officials are investigating Centene, the nation’s largest Medicaid managed care provider. The problem is said to be related to a report that the company effectively billed the state of Ohio for duplicate services while working with CVS Health. Results of the investigation could shine a light on PBM practices in Ohio and other states and lead the way toward an alternative payment model such as NADAC. The Ohio Capital Journal is an independent, non-profit publication that focuses on Ohio government.
NCPA Supports Implementation of EPCS Rule
by January 1, 2021 Deadline
Late last week, NCPA joined a coalition of stakeholders before the Office of Management and Budget in support of implementation of the e-Prescribing for Controlled Substances (EPCS) rule on the statutory deadline of January 1, 2021. EPCS is a tool in combatting the opioid epidemic and can assist in reducing fraudulent prescriptions without negative impacts on care or significant interruptions of access to prescription drugs under Medicare Part D. Currently, upwards of 98% of pharmacies are equipped to comply with EPCS. On Wednesday, NCPA and the coalition met with Kim Brandt, the Principal Deputy Administrator for Policy & Operations at CMS to further discuss EPCS implementation. CMS is planning on releasing a request for information, although that date is yet undetermined, and NCPA will provide comments at that time.
340B Community Raises Concerns Over Changes
to Manufacturer-Contract Pharmacy Relationship
Recently, Eli Lilly made the decision to no longer pay contract pharmacies for filling three formulations of Cialis prescriptions provided by 340B entities when it is shipped directly to the pharmacy. At this time, the Health Resources and Services Administration (HRSA) has determined they have insufficient legal authority to challenge such a determination. To date, this has been the only effective change in the relationship between drug manufacturers and contract pharmacies, although the 340B Health coalition – which counts a number of covered entities among its membership - is concerned manufacturers might extend the policy to other pharmaceuticals. 340B Health wrote Secretary Azar to voice their opinion Lilly’s decision circumvents the 340B statutory requirements and HRSA’s decision constitutes a “dangerous precedent.”
NCPA Continues to Advocate on Behalf of Tricare Pharmacies
Targeted by ESI and DHA
This week, NCPA joined the Alliance for Pharmacy Compounding and PAAS on a letter to Defense Health Agency regarding recoupment efforts by ESI on behalf do the agency for Tricare prescriptions filled in 2015. While the recoupments are temporarily on hold, the organizations continued the push for Express Scripts to rescind its overreaching demand letter for recoupment actions on compounded meds for Tricare beneficiaries and to restore already recouped amounts.
Have You Registered for the 2020 NCPA Annual Convention?
The NCPA 2020 Annual Convention will take place Oct. 17-20 in Nashville, Tenn. Don’t miss out on your opportunity to connect with your colleagues and attend programming that will provide you with all the information needed to answer your frequently asked questions regarding social media, audits, natural products, medical at home and a host of other topics. Click here to register if you have not yet done so. For more, view the preliminary convention schedule.
Help NCPA tell your story by completing
the Annual Census Survey
NCPA’s Annual Census Survey is now open. This is your chance to be part of the bigger story to enable NCPA to communicate to legislators, regulators, the media, and patients the important role independent pharmacies play in their communities. All we need is 8-9 minutes of your time, and you can take the census on your mobile phone, tablet, or desktop computer. Please complete by Friday, Aug. 21.
NCPA State Legislative Activity Update
NCPA tracks state legislation related to our top three state priorities: Medicaid reform, scope of practice and compensation for services, and PBM reform and regulation. Click each issue for a report of bills that have been introduced so far this session specifically dealing with these three issue areas. You can access the individual bill language and basic information on the bill by clicking on the bill numbers in the attached report. Bills that have moved this week are listed at the top in the “Recently Updated” section.
NCPA’s Advocacy Center Update provides a weekly detailed summary of recent and breaking legislative, regulatory, and state developments impacting independent community pharmacy and NCPA’s efforts to affect policies benefitting its membership and the industry. The weekly update is distributed to NCPA leadership, steering committees, allied organizations/stakeholders and major contributors to the NCPA LDF and PAC